Pinched Nerve Versus Disc Pain and the Proper Treatment

It is important for both patients and doctors to have a strong understanding of the different conditions within spinal disc pathology, especially when discussing treatments. Different spinal disc conditions require different treatments to alleviate the pain. The key factor in the clinical diagnosis is to determine whether the patient has a pinched nerve or if the disc space itself is generating the pain. These two common conditions produce different types of pain.

• Pinched nerve: When a patient has a symptomatic herniated disc, it is not the disc space itself that hurts, but rather the disc herniation is pinching a nerve in the spine. This produces pain that is called radicular pain (e.g., nerve root pain).

On Spine-health.com, this type of condition is referred to as a herniated disc.

• Disc pain: When a patient has a symptomatic degenerated disc (one that causes low back pain and/or leg pain), it is the disc space itself that is painful and is the source of pain. This type of pain is typically called axial pain.

On Spine-health.com, this type of condition is referred to as a degenerative disc disease.

It should be kept in mind that all the terms – herniated disc, pinched nerve, bulging disc, slipped disc, ruptured disc, etc.– refer to radiographic findings seen on a CT scan or MRI scan. While these test results are important, they are not as meaningful in determining the cause of the pain as the patient's specific symptoms and the doctor's physical exam results.

Herniated Disc and Degenerative Disc Disease Treatments Differ

It's critical to accurately diagnose the underlying cause of pain, because this dictates the treatment options, and the treatments for the different diagnoses vary considerably.

For example, treating a lumbar herniated disc will not do the patient much good if it is a muscle strain or other soft tissue injury rather than the disc herniation that is the cause of the patient’s pain. This is particularly important for patients who might be considering surgery.

Spine surgery can only alleviate a patient's pain if the herniated disc or degenerated disc seen on the MRI is the actual cause of the pain; surgery is not appropriate in cases where disc degeneration or a herniated disc are not likely to be the cause of a patient’s pain, or in situations where the patient has chronic pain but the exact source or pain cannot be identified.

For more information and treatment options on a pinched nerve that causes radicular pain, see articles on herniated disc or disc herniation (the chosen terminology on Spine-health.com), such as:

• Overview of lumbar disc herniation
• Treatment options for a lumbar herniated disk
• Overview of cervical disc herniation
• What you need to know about sciatica
• Upper back pain from a thoracic herniated disc

For more information and treatment options for disc space pain, see articles on degenerative disc disease, such as:

• Overview of lumbar degenerative disc disease
• Overview of cervical degenerative disc disease
• What is degenerative disc disease?
• Low back pain and degenerative disc disease treatments